Post-op check up (day #13)

Today, we went to the doctor's office for my post-op visit. There are no stitches or staples to remove, so it was really just a check on the wound and a discussion of what my restrictions are now. It was a case study in the good, the bad and the weird.

First, the good: I only have to do the continuous passive motion machine for another week. And I've been given an out. If I can find a way to start the next stage of rehab early, I can ditch the CPM as soon as I have it arranged. So now I just have to find a stationary bike that I can ride for an hour a day. He also cleared me to swim or walk in a pool. So I'll be getting off the couch momentarily. That's incredibly good, since I was about to chew my leg off like a raccoon in one of those traps with the shiny things and the nails. (Never mind. Just re-read "Where the Red Fern Grows" if you didn't catch that one.)

Now, the bad: They want me to wean off my pain medicine. Which is good- this whole bowel regimen thing stinks. And so does being sleepy so much of the time. And so does the itching. But it's also scary. They are telling me that right about now, I should be turning the corner and my medication needs should be decreasing drastically. Physiologically, that makes sense. This is about the time that the bones will have fused enough to not be moving around against each other causing pain, even if they aren't strong enough to stand on. And I do see that somewhat.

But last night, for the first time since leaving the hospital I was awakened from sleep by gnawing pain and an inability to get comfortable every time my Percocet wore off. And that was on top of the MS Contin. Then, today when I was up and around and going to the grocery store (in a wheelchair) and cooking (on crutches) I was fine and needed no Percocet. Until the MS Contin began to wear off. And now I am back on the couch waiting for it to kick in. So I'm a bit skeptical that I'm ready for this.

But I know from being on the other side of this interaction, what exactly it looks like when a patient is dragging her feet about stopping narcotics. And one of my biggest fears about this surgery was getting hooked on painkillers. What if I trust my gut and decide to keep going on the meds until I feel ready to wean? That sounds great except for the part where I run out of medication and have not yet completed an appropriate taper and have to choose between asking a doctor for more medication that I know he feels is inappropriate or undergoing a severely uncomfortable (but not life-threatening! Hooray!) withdrawal syndrome.

And finally, the weird: Yesterday, I accidentally ripped off about half of the Steri-strips holding my incision together while dropping my pants to pee. When Eric saw the resulting carnage of flopping tape and perfectly healthy skin underlying it, he moved quickly (and without any warning, the bastard) and yanked off the rest of the strips. The surgeon looked at it and agreed that the incision looked great, but was worried about it. Because the wound is a foot long, goes against the skin fold lines and passes through the sweaty fold of the groin (Mmmmm...sweaty fold), he thinks that it is at high risk for re-opening. Unfortunately, my eczema has had things to say about the stress of surgery and the sheer number of exposures to sticky tapes and dressings. There is a lot of irritation where the Steri-strips were. So he decided to forgo putting those back on and has asked me to use an apparently time-honored technique recommended by the plastic surgeons for scar healing- paper tape.

Whaaa?

So I'm supposed to put paper tape on my incision. The stuff that is notorious throughout the medical world for falling off if you sneeze near it is going to hold a 12-inch wound together? Sure, there are sutures under the skin and all. But paper tape? My unofficial poll (n=4 doctors, including me) went something like this...

Me: Have you ever heard of this?
Eric: Sure. The plastic surgeons use it all the time.
Me: Do you use it?
Eric: [insert jargon about Langerhans and partial nephrectomy incisions here to get us to a short answer of] No. But you should.

Me: Have you ever heard of this?
Dan/Denise: No. Sounds like voo-doo to me.
Me: Yeah, that's what I thought, too.
Dan/Denise: You should probably do it anyway.
Me: Oh, I totally will.

So. we're agreed. Paper taping the incision it is. Anyone digs up a reference on this and I'll buy you dinner. Not you, Eric- I buy you dinner every night.